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Very little is known about the risk of developing psychological morbidities among adults living with cerebral palsy (CP) or spina bifida (SB). The objective of this study was to compare the incidence of and adjusted hazards for psychological morbidities among adults with and without CP or SB.
Privately insured beneficiaries were included if they had an International Classification of Diseases, Ninth revision, Clinical Modification diagnostic code for CP or SB (n = 15 302). Adults without CP or SB were also included (n = 1 935 480). Incidence estimates of common psychological morbidities were compared at 4-years of enrollment. Survival models were used to quantify unadjusted and adjusted hazard ratios for incident psychological morbidities.
Adults living with CP or SB had a higher 4-year incidence of any psychological morbidity (38.8% v. 24.2%) as compared to adults without CP or SB, and differences were to a clinically meaningful extent. Fully adjusted survival models demonstrated that adults with CP or SB had a greater hazard for any psychological morbidity [hazard ratio (HR): 1.60; 95% CI 1.55–1.65], and all but one psychological disorder (alcohol-related disorders), and ranged from HR: 1.32 (1.23, 1.42) for substance disorders, to HR: 4.12 (3.24, 5.25) for impulse control disorders.
Adults with CP or SB have a significantly higher incidence of and risk for common psychological morbidities, as compared to adults without CP or SB. Efforts are needed to facilitate the development of improved clinical screening algorithms and early interventions to reduce the risk of disease onset/progression in these higher-risk populations.
OBJECTIVES/GOALS: The extent that Clinical and Translational Science Award (CTSA) programs offer resources accessible online for training in community-engaged research (CEnR) core competencies is unknown. This study cataloged CEnR resources accessible online from CTSAs and mapped resources to CEnR core competencies. METHODS/STUDY POPULATION: Eight domains of CEnR core competencies were identified: knowledge/perceptions of CEnR; personal traits necessary for CEnR; knowledge of/relationships with communities; training for performing CEnR; CEnR methods; program evaluation; resource sharing and communication; and dissemination and advocacy. A systematic review of CEnR resources accessible online from CTSAs was conducted between July 2018 and May 2019. Resource content was independently reviewed by two reviewers and scored for inclusion of each domain of CEnR core competencies. Domain scores across all resources and inter-rater reliability in scoring domains were assessed using descriptive statistics and Cohen’s kappa coefficients. RESULTS/ANTICIPATED RESULTS: Overall, 214 resources available from 24 CTSAs were eligible for full review. Scoring discrepancies for at least one domain within a resource initially occurred in 51% of resources. “CEnR methods” (50.5%; 108 of 214) and “Knowledge of/relationships with the community” (40.2%; 86 of 214) were most frequently addressed and “Program evaluation” (12.1%; 26 of 214) and “Dissemination and advocacy” (11.2%; 24 of 214) were least frequently addressed domains. Additionally, challenges were noted in navigating CTSA websites to access CEnR resources, and CEnR competency nomenclature was not standardized. DISCUSSION/SIGNIFICANCE OF IMPACT: Our findings guide CEnR stakeholders to identify CEnR resources accessible online and gaps to address in CEnR resource development. Standardized nomenclature for CEnR competencies is needed for effective CEnR resource classification. Uniform organization of CTSA websites may maximize navigability. CONFLICT OF INTEREST DESCRIPTION: In addition to the funding information listed previously (see above), within the last three years, R.J. Piasecki has been employed as: Project Coordinator, CEnR Online Learning Project, Johns Hopkins University School of Nursing (Current) Temporary Employee (Doctoral Student Intern), Michigan State University Institute for Health Policy (Current) Clinical RN, Intrastaff at the Johns Hopkins Health System (Past) Research Data Analysis Assistant, Maryland Institute for Emergency Medical Services (Past - contracted)
This project will work closely with existing service partners involved in street level services and focus on testing and evaluating three approaches for street level interventions for youth who are homeless and who have severe or moderate mentally illness. Youth will be asked to choose their preferred service approach:
Housing First related initiatives focused on interventions designed to move youth to appropriate and available housing and ongoing housing supports.
Treatment First initiatives to provide Mental Health/Addiction supports and treatment solutions, and; Simultaneous attention to both Housing and Treatment Together
Our primary objective is to understand the service delivery preferences of homeless youth and understand the outcomes of these choices. Our research questions include:
1. Which approaches to service are chosen by youth?
2. What are the differences and similarities between groups choosing each approach?
3. What are the critical ingredients needed to effectively implement services for homeless youth from the perspectives of youth, families and service providers?
Focus groups with staff and family members will occur to assist in understanding the nature of each of service approach, changes that evolve within services, & facilitators and barriers to service delivery. This work will be important in determining which approach is chosen by youth and why. Evaluating the outcomes with each choice will provide valuable information about outcomes for the service options chosen by youth. This assist in better identifying weaknesses in the services offered and inform further development of treatment options that youth will accept.
We describe an ultra-wide-bandwidth, low-frequency receiver recently installed on the Parkes radio telescope. The receiver system provides continuous frequency coverage from 704 to 4032 MHz. For much of the band (
), the system temperature is approximately 22 K and the receiver system remains in a linear regime even in the presence of strong mobile phone transmissions. We discuss the scientific and technical aspects of the new receiver, including its astronomical objectives, as well as the feed, receiver, digitiser, and signal processor design. We describe the pipeline routines that form the archive-ready data products and how those data files can be accessed from the archives. The system performance is quantified, including the system noise and linearity, beam shape, antenna efficiency, polarisation calibration, and timing stability.
The past decade has seen a rapid increase in the number of studies employing psychophysiological methods to explain variation in political attitudes and behavior. However, the collection, analysis, and interpretation of physiological data present novel challenges for political scientists unfamiliar with the underlying biological concepts and technical skills necessary for utilizing this approach. Our objective in this article is to maximize the effectiveness of future work utilizing psychophysiological measurement by providing guidance on how the techniques can be employed most fruitfully as a complement to, not a replacement for, existing methods. We develop clear, step-by-step instructions for how physiological research should be conducted and provide a discussion of the issues commonly faced by scholars working with these measures. Our hope is that this article will be a useful resource for both neophytes and experienced scholars in lowering the start-up costs to doing this work and assessing it as part of the peer review process. More broadly, in the spirit of the open science framework, we aim to foster increased communication, collaboration, and replication of findings across political science labs utilizing psychophysiological methods.
Studies of the political organisation of the Meroitic state (c.350 BC–AD 300) have often underlined the importance of an explicit recognition of its Sudanic context, and place within longer-term traditions of Sudanic political developments. Its study may also benefit from a more explicit engagement with African political anthropology, along with a greater concern with political practices, as more recently envisaged by Smith. In turn, it may also be argued that many features of early Sudanic polities of the Middle Nile (for example, Kerma) differ in some fundamental ways from their northern neighbours of the Egyptian Lower Nile, or indeed the Mediterranean. Meroe shares a number of distinctive characteristics of more recent Sudanic kingdoms; some are emphasised in this chapter. A number of challenges to rulership are readily identifiable in the Sahelian-Sudanic landscapes of the Middle Nile, and many of these may be familiar to those working in other contexts across the continent.
A theory of magnitudes involves criteria for their equivalence, comparison and addition. In this article we examine these aspects from an abstract viewpoint, by focusing on the so-called De Zolt’s postulate in the theory of equivalence of plane polygons (“If a polygon is divided into polygonal parts in any given way, then the union of all but one of these parts is not equivalent to the given polygon”). We formulate an abstract version of this postulate and derive it from some selected principles for magnitudes. We also formulate and derive an abstract version of Euclid’s Common Notion 5 (“The whole is greater than the part”), and analyze its logical relation to the former proposition. These results prove to be relevant for the clarification of some key conceptual aspects of Hilbert’s proof of De Zolt’s postulate, in his classical Foundations of Geometry (1899). Furthermore, our abstract treatment of this central proposition provides interesting insights for the development of a well-behaved theory of compatible magnitudes.
The rocky shores of the north-east Atlantic have been long studied. Our focus is from Gibraltar to Norway plus the Azores and Iceland. Phylogeographic processes shape biogeographic patterns of biodiversity. Long-term and broadscale studies have shown the responses of biota to past climate fluctuations and more recent anthropogenic climate change. Inter- and intra-specific species interactions along sharp local environmental gradients shape distributions and community structure and hence ecosystem functioning. Shifts in domination by fucoids in shelter to barnacles/mussels in exposure are mediated by grazing by patellid limpets. Further south fucoids become increasingly rare, with species disappearing or restricted to estuarine refuges, caused by greater desiccation and grazing pressure. Mesoscale processes influence bottom-up nutrient forcing and larval supply, hence affecting species abundance and distribution, and can be proximate factors setting range edges (e.g., the English Channel, the Iberian Peninsula). Impacts of invasive non-native species are reviewed. Knowledge gaps such as the work on rockpools and host–parasite dynamics are also outlined.
Shallow granular avalanches on slopes close to repose exhibit hysteretic behaviour. For instance, when a steady-uniform granular flow is brought to rest it leaves a deposit of thickness
on a rough slope inclined at an angle
to the horizontal. However, this layer will not spontaneously start to flow again until it is inclined to a higher angle
, or the thickness is increased to
. This simple phenomenology leads to a rich variety of flows with co-existing regions of solid-like and fluid-like granular behaviour that evolve in space and time. In particular, frictional hysteresis is directly responsible for the spontaneous formation of self-channelized flows with static levees, retrogressive failures as well as erosion–deposition waves that travel through the material. This paper is motivated by the experimental observation that a travelling-wave develops, when a steady uniform flow of carborundum particles on a bed of larger glass beads, runs out to leave a deposit that is approximately equal to
. Numerical simulations using the friction law originally proposed by Edwards et al. (J. Fluid Mech., vol. 823, 2017, pp. 278–315) and modified here, demonstrate that there are in fact two travelling waves. One that marks the trailing edge of the steady-uniform flow and another that rapidly deposits the particles, directly connecting the point of minimum dynamic friction (at thickness
) with the deposited layer. The first wave moves slightly faster than the second wave, and so there is a slowly expanding region between them in which the flow thins and the particles slow down. An exact inviscid solution for the second travelling wave is derived and it is shown that for a steady-uniform flow of thickness
it produces a deposit close to
for all inclination angles. Numerical simulations show that the two-wave structure deposits layers that are approximately equal to
for all initial thicknesses. This insensitivity to the initial conditions implies that
is a universal quantity, at least for carborundum particles on a bed of larger glass beads. Numerical simulations are therefore able to capture the complete experimental staircase procedure, which is commonly used to determine the
curves by progressively increasing the inclination of the chute. In general, however, the deposit thickness may depend on the depth of the flowing layer that generated it, so the most robust way to determine
is to measure the deposit thickness from a flow that was moving at the minimum steady-uniform velocity. Finally, some of the pathologies in earlier non-monotonic friction laws are discussed and it is explicitly shown that with these models either steadily travelling deposition waves do not form or they do not leave the correct deposit depth
Principia Logico-Metaphysica contains a foundational logical theory for metaphysics, mathematics, and the sciences. It includes a canonical development of Abstract Object Theory [AOT], a metaphysical theory (inspired by ideas of Ernst Mally, formalized by Zalta) that distinguishes between ordinary and abstract objects.
This article reports on recent work in which AOT has been successfully represented and partly automated in the proof assistant system Isabelle/HOL. Initial experiments within this framework reveal a crucial but overlooked fact: a deeply-rooted and known paradox is reintroduced in AOT when the logic of complex terms is simply adjoined to AOT’s specially formulated comprehension principle for relations. This result constitutes a new and important paradox, given how much expressive and analytic power is contributed by having the two kinds of complex terms in the system. Its discovery is the highlight of our joint project and provides strong evidence for a new kind of scientific practice in philosophy, namely, computational metaphysics.
Our results were made technically possible by a suitable adaptation of Benzmüller’s metalogical approach to universal reasoning by semantically embedding theories in classical higher-order logic. This approach enables one to reuse state-of-the-art higher-order proof assistants, such as Isabelle/HOL, for mechanizing and experimentally exploring challenging logics and theories such as AOT. Our results also provide a fresh perspective on the question of whether relational type theory or functional type theory better serves as a foundation for logic and metaphysics.
A national need is to prepare for and respond to accidental or intentional disasters categorized as chemical, biological, radiological, nuclear, or explosive (CBRNE). These incidents require specific subject-matter expertise, yet have commonalities. We identify 7 core elements comprising CBRNE science that require integration for effective preparedness planning and public health and medical response and recovery. These core elements are (1) basic and clinical sciences, (2) modeling and systems management, (3) planning, (4) response and incident management, (5) recovery and resilience, (6) lessons learned, and (7) continuous improvement. A key feature is the ability of relevant subject matter experts to integrate information into response operations. We propose the CBRNE medical operations science support expert as a professional who (1) understands that CBRNE incidents require an integrated systems approach, (2) understands the key functions and contributions of CBRNE science practitioners, (3) helps direct strategic and tactical CBRNE planning and responses through first-hand experience, and (4) provides advice to senior decision-makers managing response activities. Recognition of both CBRNE science as a distinct competency and the establishment of the CBRNE medical operations science support expert informs the public of the enormous progress made, broadcasts opportunities for new talent, and enhances the sophistication and analytic expertise of senior managers planning for and responding to CBRNE incidents.
When a layer of static grains on a sufficiently steep slope is disturbed, an upslope-propagating erosion wave, or retrogressive failure, may form that separates the initially static material from a downslope region of flowing grains. This paper shows that a relatively simple depth-averaged avalanche model with frictional hysteresis is sufficient to capture a planar retrogressive failure that is independent of the cross-slope coordinate. The hysteresis is modelled with a non-monotonic effective basal friction law that has static, intermediate (velocity decreasing) and dynamic (velocity increasing) regimes. Both experiments and time-dependent numerical simulations show that steadily travelling retrogressive waves rapidly form in this system and a travelling wave ansatz is therefore used to derive a one-dimensional depth-averaged exact solution. The speed of the wave is determined by a critical point in the ordinary differential equation for the thickness. The critical point lies in the intermediate frictional regime, at the point where the friction exactly balances the downslope component of gravity. The retrogressive wave is therefore a sensitive test of the functional form of the friction law in this regime, where steady uniform flows are unstable and so cannot be used to determine the friction law directly. Upper and lower bounds for the existence of retrogressive waves in terms of the initial layer depth and the slope inclination are found and shown to be in good agreement with the experimentally determined phase diagram. For the friction law proposed by Edwards et al. (J. Fluid. Mech., vol. 823, 2017, pp. 278–315, J. Fluid. Mech., 2019, (submitted)) the magnitude of the wave speed is slightly under-predicted, but, for a given initial layer thickness, the exact solution accurately predicts an increase in the wave speed with higher inclinations. The model also captures the finite wave speed at the onset of retrogressive failure observed in experiments.
The Middle Nile (from Aswan in Egypt to Khartoum in Sudan, Fig. 6.1) is quite exceptional in Sub-Saharan Africa. It is a region where, from the beginning, archaeological frameworks have been constructed largely on the basis of cemetery excavations. This has, of course, much to do with regionally specific research histories and emergent archaeological practices associated with them. The traditions of materially rich mortuary cultures encountered in the Middle Nile, dating back to the early Neolithic period (here the sixth millennium BC), has continued to attract significant archaeological attention. Numerous, often large, cemeteries are still routinely being explored within the context of both research and rescue archaeology. Their material abundance continues to fascinate. The first extensive archaeological survey of Nubia, completed in 1911, excavated more than 8,200 graves in 151 cemeteries within a ‘survey’ area limited to the riverine oasis and covering an area of less than 250 km2.
There is community concern about the treatment of farm animals post-farm gate, particularly animal transport and slaughter. Relationships between lamb behavioural and physiological variables on farm, stockperson, dog and lamb behavioural variables pre-slaughter and plasma cortisol, glucose and lactate in lambs post-slaughter were studied in 400 lambs. The lambs were observed in three behavioural tests, novel arena, flight distance to a human and temperament tests, before transport for slaughter. Closed-circuit television video footage was used to record stockperson, dog and lamb behaviour immediately before slaughter. Blood samples for cortisol, glucose and lactate analyses were collected on farm following the three behavioural tests and immediately post-slaughter. The regression models that best predicted plasma cortisol, glucose and lactate concentrations post-slaughter included a mixture of stockperson and dog behavioural variables as well as lamb variables both on-farm and pre-slaughter. These regression models accounted for 33%, 34% and 44% of the variance in plasma cortisol, glucose and lactate concentrations post-slaughter, respectively. Some of the stockperson and dog behaviours pre-slaughter that were predictive of the stress and metabolic variables post-slaughter included the duration of negative stockperson behaviours such as fast locomotion and lifting/pulling lambs, and the duration of dog behaviours such as lunging and barking at the lamb, while some of the predictive lamb behaviour variables included the durations of jumping and fleeing. Some of the physiological and behavioural responses to the behavioural tests on farm were also predictive of the stress and metabolic variables post-slaughter. These relationships support the well-demonstrated effect of handling on fear and stress responses in livestock, and although not direct evidence of causal relationships, highlight the potential benefits of training stockpeople to reduce fear and stress in sheep at abattoirs.
Objectives: Caregivers of youth with heavy prenatal alcohol exposure report impaired communication, which can significantly impact quality of life. Using data collected as part of the Collaborative Initiative on Fetal Alcohol Spectrum Disorders (CIFASD), we examined whether cognitive variables predict communication ability of youth with histories of heavy prenatal alcohol exposure. Methods: Subjects (ages 10–16 years) comprised two groups: adolescents with heavy prenatal alcohol exposure (AE) and non-exposed controls (CON). Selected measures of executive function (NEPSY, Delis-Kaplan Executive Function System), working memory (CANTAB), and language were tested in the child, while parents completed communication ratings (Vineland Adaptive Behavior Scales – Second Edition). Separate multiple regression analyses determined which cognitive domains predicted communication ability. A final, global model of communication comprised the three cognitive models. Results: Spatial Working Memory and Inhibition significantly contributed to communication ability across groups. Twenty Questions performance related to communication ability in the CON group only while Word Generation performance related to communication ability in the AE group only. Effects remained significant in the global model, with the exception of Spatial Working Memory. Conclusions: Both groups displayed a relation between communication and Spatial Working Memory and Inhibition. Stronger communication ability related to stronger verbal fluency in the AE group and Twenty Questions performance in the CON group. These findings suggest that alcohol-exposed adolescents may rely more heavily on learned verbal storage or fluency for daily communication while non-exposed adolescents may rely more heavily on abstract thinking and verbal efficiency. Interventions aimed at aspects of executive function may be most effective at improving communication ability of these individuals. (JINS, 2018, 24, 1026–1037)